Project Summary/Abstract: Community Outreach and Engagement The Dartmouth-Hitchcock Norris Cotton Cancer Center (NCCC) is unique among NCI-designated Cancer Centers as the only one in Northern New England (VT, NH, ME), the one located in the smallest town, and as one of the few whose catchment area has a population that is almost half rural (48%), does not contain a major urban core, and has nine of 24 counties classified as 7, 8, or 9 (isolated rural) according to the Rural Urban Continuum Codes (RUCCs). While the population within our catchment area is not as racially/ethnically heterogeneous as some, social determinants in our largely rural communities ? particularly age, income, and education play an important role in cancer-related health behaviors, risk, early detection, treatment, and survivorship. Disparities along the cancer control continuum between our rural and non-rural populations have been documented, spurring distinct research and intervention needs. Our catchment area carries a disproportionate burden in cancer incidence, leading to both cancer-related mortality, and a growing population of cancer survivors. NCCC plays a unique and substantive role in our communities?engaging the populations within our catchment area and focusing research on locally-relevant issues to translate evidence into impactful benefits for individuals and communities, with research that is often generalizable to other populations. While NCCC has served this overarching mission for decades, the recent formalization of the Community Outreach and Engagement (COE) component of the CCSG will catalyze NCCC to identify and address the needs of our catchment area in a more comprehensive, cohesive, nimble and timely way as we work in concert with NCCC?s Research Programs to accomplish three aims. These are: 1) To identify, measure, and monitor the cancer control needs and cancer health equity issues throughout the catchment area through engagement of a Community Advisory Board, observational studies and surveillance of health system, state, and national data; 2) To address the cancer control needs and cancer health equity issues of our catchment area through community-engaged interventions, increased participation in clinical trials, and regional collaborations, with an emphasis on rural and underserved populations; and 3) To promote cancer research findings from the four NCCC scientific programs across the cancer control continuum for translation into sustainable policy, program, and health system enhancements. We will apply metrics to track relevance and impact of research related to cancer biology, clinical research, cancer-related health equity, prevention, and control within our catchment area (surveillance and community metrics) and what are we doing about it (engagement, collaboration, and research metrics). The COE initiative will build upon a strong existing base of community and regional partnerships. By achieving the COE aims, we will ensure that we are having the most meaningful impact on how cancer affects the lives of those in our region, and we will develop a solid infrastructure for sustaining those positive impacts and strengthening translation of NCCC research.